OrganizationActive
Ikdo State Street LLC
NPI 1932683752 · Orthodontics and Dentofacial Orthopedics Dentistry · Garden City, ID
Provider details
- NPI number
- 1932683752
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jaycie Birch, Office Manager(208) 388-1111
Specialties & taxonomies
Dental Providers
- Pediatric Dentistry1223P0221X
Dental Providers
Practice location
9209 W State St
Garden City, ID 83714
Phone: (208) 388-1111
Approximate (ZIP-level) locationGet directions
Mailing address
9209 W State St
Garden City, ID 83714
Registry dates
- Enumerated
- 2018-09-18
- Last updated
- 2018-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.